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Anatomy > Inguinal Regions And Hernias > Flashcards

Inguinal Regions And Hernias Flashcards

1
Q

What is hernia in the abdominal wall?

A

It is a protrusion in the abdominal wall due to weakness anterior abdominal muscle

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2
Q

List some of the most common hernias.

A

Inguinal
Umbilical
Femoral

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3
Q

List hernias which could be caused by chronic cough, vomiting, constipation etc.

A

Epigastric

Spegelian

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4
Q

From which root level do gonads descend from?

A

Posterior walls L2

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5
Q

What is the position of inguinal hernia in relation to inguinal ligament and the pubic tubercle?

A

Superior to inguinal ligament

Medial to pubic tubercle

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6
Q

What is the position of femoral hernia in relation to inguinal ligament and the pubic tubercle?

A

Inferior to inguinal ligament

Lateral to pubic tubercle

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7
Q

What features are available in inguinal canal which prevent prolapse of abdominal viscera?

A

Inguinal canal has tight staggered opening in each layer

Also it runs obliquely, so difficult for viscera to enter the canal

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8
Q

How is inguinal ligament formed?

A

It is formed by the inferior portion of external oblique muscle aponeurosis which infold to create a thick fibrous band

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9
Q

What are the attachments of inguinal ligament?

A

From anterior superior illiac spine to the pubic tubercle

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10
Q

What kind of opening does external inguinal ring has?

A

Slit like opening

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11
Q

What is the name of the lateral and medial margins of the opening of external inguinal righ?

A

Crura

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12
Q

What is the insertion of lateral crus of external inguinal ring?

A

Pubic tubercle

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13
Q

What is the insertion of medial crura in external inguinal ring?

A

Pubic crest

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14
Q

Intercrural fibre

A

Fibres which arise from inguinal ligament lateral to the external inguinal ring, arch superiolaterally

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15
Q

What is the function of Intercrural fibres?

A

Helps prevent the crura from expanding

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16
Q

What is the length of the inguinal canal?

A

Approximate 4cm

17
Q

In terms of its position, what is the relationship between inguinal ligament and inguinal canal?

A

The canal lies parallel and 2 to 4 cm superior to the medial half of the inguinal canal

18
Q

What is the position of deep inguinal ring?

A

Deep inguinal ring lies 1.25cm superior to the middle of the inguinal ligament and lateral to the inferior epigastric artery (which branch from external illiac artery)

19
Q

T/F transversalis fascia is the very first evagination to make the opening of deep inguinal ring

A

True

20
Q

Does transversalis fascia continue into the inguinal canal?

A

Yes, it continues into the canal forming interal fascia of the structure

21
Q

How is conjoint tendon formed?

A

By arching of transversus abdimjnis and internal oblique muscle which join together

22
Q

How are cremaster muscle and fascia formed?

A

It is formed when arched internal oblique muscle slips some of it muscle to the inguinal ring

23
Q

What are the insertion of conjoint tendon?

A

It inserts medially to linea alba and lateral border is free

It also inserts to the pectineal ligament along the superior ramps of the pubis

24
Q

What is gubercnaculum?

A

It is a fibrous cord which is used to guide testis into scrotum from posterior abdominal wall

25
Q

What is the fate of gubernaculum?

A

The proximal portion of gubernaculum disintegrates as gonads descends to form scrotum
A small amount of gubernaculum remains after gonads reaches scrotum. This is called scrotal ligament and it attaches testis to the scrotal wall.

26
Q

T/F as gonads move from posterior abdominal wall, it creates a whole in anteriolateral abdominal wall?

A

False, gonads evaginate to create finger like processes, taking sleeves of the wall with it as it moves.

27
Q

Describe the state of each layer of anteriolateral abdominal wall as gonads make its way to the scrotum?

A

Firstly, an indentation is made in transversalis fascia (this fascia goes into the canal).
Secondly, gonads pass under transversus abdiminis muscle.
Thirdly, gonads pass under internal oblique muscle but it slips some of its muscle into the canal to form cremaster muscle and cremaster fascia.
Lastly, gonads sleeve external oblique muscle and makes its way to the scrotum

28
Q

Name all the layers of spermatic cord? Superficial to deep

A

External spermatic fascia
Cremaster muscle
Cremaster fascia
Internal spermatic fascia

29
Q

What is processus veginalis?

A

It is protrusion parietal peritoneum which moves along behind with gonads

30
Q

What is tunica veginalis?

A

When terminal portion of processus vaginalis bud off, it isolates a bit of parietal peritoneum called tunica vaginalis which cushions the testis.

Note: cough test can detect attached processus vaginalis after birth

31
Q

What are the constituents of spermatic cord?

A

Ductus (vas) deferens
Testicular artery
The panini form plexus of veins
Lymph vessels
Sympathetic fibres of the arteries and both symp and parasymp fibres of ductus deferens
Genital branch of genitofemoral nerve into spermatic cord supplying cremaster muscle

32
Q

Why do testis need to travel to scrum? Why can’t it just stay in posterior abdominal wall?

A

For effective production and survival of sperms, it needs cooler environment and scrotum provides that environment

33
Q

How does scrotum gets close the the body to increase its internal temperature?

A

This action is mediated by cremaster muscle of the spermatic cord

34
Q

State what are in the medial, lateral and inferior border of the inguinal triangle?

A

Medial: lateral margin of rectus abdominis, linea semilunaris
Lateral: inferior epigastric vessels
Inferior: inguinal ligament

35
Q

Why does the upper half wall of inguinal triangle stronger the lower half?

A

The upper half is made of conjoint tendon whereas the lower half wall consist of inguinal ring only and no external oblique muscle thus weak

36
Q

What is direct inguinal hernia?

A

It is a protrusion of through the lower half of the inguinal triangle

37
Q

What are the body’s measure to prevent herniation in inguinal triangle?

A

Conjoint tendon pulls itself like a shutter as it contracts preventing abdominal viscera to protrude any weak wall
Also, obliquity of the inguinal canal prevents any easy access for abdominal viscera

38
Q

Since L1 supplies inguinal regions of the body, what could be the implication if there is any damage to L1 vertebra?

A

It may lead to direct herniation of the inguinal triangle

39
Q

What is indirect inguinal hernia?

A

It is a hernia when perietal peritoneum of the abdomen protrudes through the deep inguinal ring, travel the length of inguinal canal and exit where the wall is weaker ie the external inguinal ring

Anatomy (3 decks)

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